While the approval and subsequent roll-out of vaccines to fight coronavirus have provided much-needed hope for the nation, the actual process of doing this appears to be piling pressure on GP practices while also confusing patients.
Several practice managers have reported problems with how the process is unfolding and their practices are continuing to be bombarded by calls from patients asking when they will receive their vaccine and why they have not yet been contacted.
All this is happening despite repeated messages from practices, the government and the media that a “don’t call us, we’ll call you” approach is meant to be happening on vaccination.
Two vaccines are being made available – the Pfizer-BioNTech version that needs to be stored at very low temperatures and the AstraZeneca/Oxford University one that merely need to be refrigerated.
The nature of the Pfizer vaccine makes it difficult for GP practices to store and then use so it has predominantly been issued at hospitals and now newly created vaccination centres.
Under the government’s vaccines delivery plan, at least 2 million vaccinations per week are to take place with more than 2,700 vaccine sites across the UK.
As the highest priority groups are vaccinated first – residents in a care home for older adults and their carers; all people 80 years of age and over; and frontline health and social care workers – it appears that different approaches are being taken over where people are being vaccinated and who is in charge of contacting patients.
This has not been helped by the fact that the Institute for General Practice Management (IGPM) found out recently that vaccine deliveries promised to so-called ‘wave one’ sites have now been delayed to allow other areas to catch up.
Helen, a practice manager from Eltham in London, admits that patients are still contacting the practice regularly, saying: “The patients are not being horrible about it but they are ringing up saying ‘when can I have it?’. We had an eConsult from a patient saying ‘can I have at the same time as my mother has it?’ and other questions.
“The problem is that they know there are the cohorts but because with flu we mix and match, they are assuming the same applies for the COVID vaccine and we have to explain ‘no, this is different’. The biggest problem is that everything changes every five minutes and nobody is pushing back and telling NHS England or the Department of Health & Social Care ‘no’ on handling the vaccine.
“In our area, we decided to hand it over to the GP federation [Greenwich Health] and they are ringing patients, booking appointments and doing it lock stock and barrel. Then they said they weren’t going to do housebound, so we have to do that part of it.
“It was all set up for the Pfizer vaccine and now AstraZeneca’s vaccine has come along and then we were told a pharmacy will be offering it. Our patients are going to get confused. Now we’ve got the Nightingale Hospital at the London ExCel doing it, but patients are asking where do I go? Patients are getting mixed messages.
“The problem with the COVID vaccinations is that every PCN and every borough is doing it differently. That doesn’t help people if they are talking to friends in different boroughs. There is a lack of consistency, changing of minds and the changing of the rules all the time. We are very frustrated.”
The IGPM is contacting NHS England to formally raise its concerns about the situation.
One of its co-directors Nicola Davies, a practice manager from Cornwall, says: “We are concerned about the lack of structure over the delivery of the vaccines to our networks and surgeries.
“We know that there are some planned deliveries where clinics have been booked to tie in with those and they now have had notice that their vaccines are not going to arrive so that means cancelling surgeries, rescheduling rotas, and organising new appointments.
“Some patients have had letters that tells them to ring surgeries about their COVID vaccine and yet these are patients who have already had the vaccination! It sounds like some information about vaccination status for patients hasn’t yet been uploaded. It emphasis that the work of the IGPM is so needed and we need to be included in these decisions.
“There are lots of phone calls about when people will be getting the vaccine. As it stands at the moment, we’ve had no vaccine. That doesn’t mean there isn’t vaccine in the county but it hasn’t come our way.”
Larger towns have received vaccines, she says, and have been able to successfully run vaccination clinics, but adds: “My issue is for those of us who are rural, I’m looking at a situation where my patients may have to drive for an hour to get to the designated sites. It puts more challenges in our way.”
Several managers commenting in a discussion thread on this subject on the Practice Index website say they are doing their best to ease confusion by using the practices’ answerphone message, Facebook posts, practice website and posters to get the message to patients.
Nevertheless, a practice manager speaking in the thread says their practice is experiencing real problems over the message about vaccines.
She says: “We calculated that across last week and the beginning of this week, 50% of calls were regarding the COVID vaccination. I ended up posting on our Facebook page and sharing this across all the local community group pages with a plea to stop calling us, we will call you, and pointing out that for every call coming in, they are potentially stopping an urgent, immediately necessary medical call from being taken.
“There needs to be a massive media campaign across the news, papers and radio instructing patients not to call the practices for this reason.”
A fellow unnamed manager has a similar problem and says: “We have the information on our website, answerphone message and poster, but we are still receiving calls, emails and eConsults.
“What does not help is that our PCN thought it would be better to vaccinate the patients ourselves as opposed to joining with all the other PCN in our borough and having one team doing all the clinics.
“I can understand people’s frustrations but it does not help that all media outlets – press, radio and TV – are banging on about all GP practices having the vaccines. It does not help also that neighbouring boroughs and counties have moved away from the 80+ patients and are vaccinating either their 75-79 or 70+ patients while we are still waiting for the opportunity to complete our 80+ patients cohort. MADNESS!”
Some practices have updated their telephone welcome messages to inform the caller that if they are calling to ask when they will have your vaccine, they should hang up and wait to be contacted, but another manager says: “It would help if the BBC didn’t keep saying ‘GPs have vaccines’!”
Another says: “It’s the same few dozen patients calling over and over, who aren’t happy with ‘don’t call us, we’ll call you’. Can be very abusive and our poor reception staff are fed up to the back teeth with it.”
Practices can only hope that the process will start to settle down soon and patients will accept their repeated calls are not helping anyone.